Osteomyelitis often includes a prolonged hospital stay and in-depth preparation for long-term care in the home. Several strategies exist to manage the discomfort of fever and pain nonphar-macologically. Encourage oral fluids to prevent dehydration because of the elevated temperature

672 Osteoporosis and infectious process. Frequent positioning and distractions help with pain control. Use imagery and relaxation techniques to help control discomfort.

To prevent contamination to other areas of the body, use various types of sterile dressings to contain the exudate from draining wounds. The most common are dry, sterile dressings; dressings saturated in saline or antibiotic solution; and wet-to-dry dressings. Use aseptic technique when you change dressings, and dispose of contaminated dressings appropriately. Universal precautions are extremely important to prevent cross-contamination of the wound or spread of the infection to other patients.

Handle the involved extremity carefully to avoid increasing pain and the risk of a pathological fracture. To provide support, immobilization, and comfort, the extremity may be splinted. Proper application of the splint is extremely important because an improperly applied device can result in pressure ulcers or nerve damage. Regular skin assessments and conscientious skin care are important to prevent pressure sores from bedrest. Good body alignment, appropriate positioning of the affected extremity, and frequent position changes for the rest of the body prevent complications and promote comfort. Flexion deformity or contractures may occur if the patient is permitted to maintain a position of comfort instead of a position of function. Foot-drop can develop quickly in the lower extremity if the foot is not correctly supported. Promote range-of-motion, isotonic, and isometric exercises for the rest of the body to maintain joint flexibility and muscle strength.

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